Glossary of Insurance Terms #2 - Paladin Risk Management
Glossary of Insurance Terms #2
ADDITIONAL INSURED
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An individual or entity that is not automatically included as an insured under the policy of another, but for whom the named insured's policy provides a certain degree of protection. An endorsement is typically required to effect additional insured status. The named insured's impetus for providing additional insured status to others may be a desire to protect the other party because of a close relationship with that party (e.g., employees or members of an insured club) or to comply with a contractual agreement requiring the named insured to do so (e.g., customers or owners of property leased by the named insured).
Copyright © 1996 Lewis-Chester Associates, Inc.
ADDITIONAL NAMED INSURED
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1. An individual or entity, other than the first named insured, identified as an insured in the policy declarations or an addendum to the policy declarations.
2. An individual or entity who is added to a policy with the status of named insured after the policy is written. Such an individual or entity would have the same rights and responsibilities as an individual or entity named as an insured in the policy declarations (other than those rights and responsibilities reserved to the first named insured). In this sense the term can be contrasted with additional insured, an individual or entity added to a policy as an insured but not as a named insured. The term additional named insured has not acquired a uniformly agreed-upon meaning within the insurance industry, and use of the term in the two different senses defined above often produces confusion in requests for additional insured status between contracting parties.
ADVERTISING INJURY LIABILITY
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"Advertising Injury" means injury rising out of an offense committed in the course of your advertising activities, if such injury rises out of libel, slander, defamation, violation of right of privacy, piracy, unfair competition or infringement of copyright, title or slogan.
AGGREGATE
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1. A limit in an insurance policy stipulating the most it will pay for all covered losses sustained during a specified period of time, usually one year. Aggregate limits are commonly included in liability policies. While not often used in property insurance, aggregates are sometimes included with respect to certain catastrophic exposures, e.g., earthquake and flood.
2. The dollar amount of reinsurance coverage during one specified period, usually 12 months, for all reinsurance losses sustained under a treaty during such period.
DEFINITION OF BINDER
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A binder is a legal agreement that serves to effect insurance coverage for a specified period of time until the actual insurance policy can be issued. A binder can be issued by either an insurance agent or company and must provide the following information:
• Name of insured
• Type of insurance coverage
• Limits of insurance
• Covered perils
• Name of insurance company
DEFINITION OF BLANKET INSURANCE
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Blanket insurance provides coverage under a single limit for the following:
• Two or more items (e.g., Building and/or Contents)
• Two or more locations (e.g., Location A and/or Location B)
• A combination of items and/or locations
BROAD FORM PROPERTY DAMAGE COVERAGE INCLUDING COMPLETED OPERATIONS
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This coverage extension is of great value to the general contractor as respects "completed operations" property damage liability claims. Without it, the normal Comprehensive General Liability policy will not respond for "completed operations" claims (i.e., claims rising out of work performed on behalf of the insured by subcontractors). With it, this exposure is covered.
Additional broadening coverage features are also included, but none as important as the above to the general contra
BROADENED NAMED INSURED WORDING
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Regarding liability coverages, these coverages will automatically apply to ". . . any affiliated, associated, allied or subsidiary company or entity (including subsidiaries thereof), now held or hereinafter acquired or constituted . . ."
COMPLETED OPERATIONS LIABILITY COVERAGE
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This form of liability insurance provides coverage for bodily injury and property damage rising from completed or abandoned operations, provided the incident occurs away from premises owned or rented by the insured.
Operations are deemed completed at the earliest of the following items:
• When all operations to be performed by or on behalf of the insured under contract have been completed.
• When all operations to be performed by or on behalf of the insured at the site of the operations have been completed.
• When the portion of work out of which injury or damage rises has been put to its intended use by a party other than the contractor or subcontractor.
COMPREHENSIVE AUTOMOBILE COVERAGE
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Brief Coverage Explanations:
• Owned Automobiles - Covers liability rising out of the ownership, maintenance or use of automobiles.
• Hired Automobiles - Covers liability for the use of hired automobiles in your business.
• Non-Owned Automobiles - Covers liability for the use of non-owned automobiles in your business. An example would be an employee using his/her own car on an errand for you.
• Uninsured Motorists - Protects insureds who are not contributorily negligent against bodily injury caused by negligent uninsured motorists.
• Comprehensive - Pays for damage to or the loss of automobiles from perils other than collision. A deductible applies.
• Collision - Pays for damage to or the loss of automobiles from upset or collision with another object. A deductible applies.
COMMERCIAL GENERAL LIABILITY COVERAGE
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Under this form of insurance and regarding a covered occurrence, the company will pay all sums the insured becomes legally obligated to pay as damages due to:
1. Bodily Injury (Coverage A)
2. Property Damage (Coverage B)
The insurance company has the right to defend any suit against the insured seeking damages on account of such bodily injury or property damage, even if any of the allegations of suit are groundless, false or fraudulent, and to make such investigation and settlement of any claim or suit as it deems expedient. However, the company is not obligated to pay any claim or judgment or to defend any suit after applicable limit of the company's liability has been exhausted by payments of judgments or settlements.
COMPREHENSIVE GENERAL LIABILITY COVERAGE
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Under this form of insurance and regarding a covered occurrence, the company will pay all sums the insured becomes legally obligated to pay as damages due to:
1. Bodily injury (Coverage A)
2. Property damage (Coverage B)
The insurance company has the right to defend any suit against the insured seeking damages for bodily injury or property damage, even if any of the allegations of suit are groundless, false, or fraudulent, and to make such investigation and settlement of any claim or suit as it deems expedient. However, the company is not obligated to pay any claim or judgment or to defend any suit after the applicable limit of the company's liability has been exhausted by payments of judgments or settlements.
DEFINITION OF CONSEQUENTIAL LOSS OR DAMAGE
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Consequential loss or damage -- as opposed to direct loss or damage -- is indirect loss or damage resulting from loss or damage caused by a covered peril, such as fire or windstorm. In the case of loss caused where windstorm is a covered peril, if a tree is blown down and cuts electricity used to power a freezer and the food in the freezer spoils, iIf the insurance policy extends coverage for consequential loss or damage then the food spoilage would be a covered loss. Business Interruption insurance extends consequential loss or damage coverage for such items as extra expenses, rental value, profits and commissions, etc.
CONTRACTOR'S LIABILITY COVERAGE
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(1)Premises/Operations
The "premises" portion of your liability insurance provides for payment on your behalf of all sums you become legally obligated to pay as damages resulting from bodily injury and/or property damage caused by an insured peril and rising out of the ownership, maintenance, or use of premises and your operations in progress.
The "operations" portion of your liability insurance covers operations in progress and is intended for situations where your principal business operations are performed away from your premises.
(2)Completed Operations
This portion of your liability insurance covers you for possible liability for bodily injury and/or property damage after your work is complete and you have left the job site.
CROSS LIABILITY COVERAGE
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In the event of claim by one insured for which another insured covered by the same policy may be held liable, this endorsement covers the insured against whom the claim is made in the same manner as if separate policies had been issued. However, it does not operate to increase the insurance company's overall limit of liability.
DRIVE OTHER CAR COVERAGE
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Coverage applicable to employees or executives of a company or any other person who is supplied a company vehicle, but who does not own a personal vehicle, thereby not having personal automobile coverage. An endorsement may be added to the automobile policy of the company that furnishes the automobile, giving protection while the named individual or a member of his family is driving a car borrowed from a third party (other than the vehicle named in the policy). Individuals who are owners of the company qualify for the "individual named insured" endorsement, which includes family coverage. The drive other car coverage is usually added at little additional premium charge.
ERRORS & OMISSIONS
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Coverage for liability resulting from errors or omissions in the performance of professional duties. Applicable as a general rule to professional business activities such as banking, accounting, law, insurance and real estate.
EXTRA EXPENSE COVERAGE
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If your building was rendered untenantable by fire or any other insured peril, it would probably be necessary to secure other quarters to continue your business operations. However, the use of such buildings would undoubtedly involve many extra expenses, such as rent, installation of telephones, etc. Extra Expense insurance covers such expenditures over and above your normal monthly expenses.
GENERAL PARTNERS' LIABILITY COVERAGE
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This type of insurance is also known as General Partners' Liability and Limited Partnership Reimbursement coverage.
A general partner's management and fiduciary responsibilities to a limited partnership closely parallel the director's or officer's to a corporation. Exposure occurs when general partners become the financial managers of a limited partnership. The directors and officers of corporate general partners share this type of exposure.
Some causes of claims are as follows:
• Untrue written or oral statements made by the general partners.
• Breach of fiduciary duty.
• Incomplete disclosure of facts.
• Omission or misleading statements in the offering memorandum.
• Selling of unregistered limited partnership interests.
• Conflict of interest.
• Failure to devote adequate time to the partnership.
• Appointment of drilling contracts without proper prior investigation as to their experience.
• Failure to minimize risk factors that prove detrimental.
EXPLANATION OF INDEMNIFICATION
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When insurance policies are written on an "indemnification" basis, the insurance company will reimburse the insured for claim costs already paid. Technically, the insured must not only suffer a loss, but must also pay the loss before being reimbursed (indemnified) by the company.
OCCURRENCE (CGL)
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This term means an accident, including continuous or repeated exposure to conditions, which results in bodily injury or property damage neither expected nor intended from the standpoint of the insured.
OWNERS' OR CONTRACTORS' PROTECTIVE LIABILITY COVERAGE
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This insurance coverage provides for payment on behalf of the insured of all damages the insured becomes legally obligated to pay due to bodily injury or property damage caused by an occurrence rising from the following:
• Operations performed for the named insured by independent contractors.
• Acts or omissions of the named insured in connection with his/her general supervision of such operations.
This does not include maintenance and repair at premises owned by or rented to the named insured, or structural alterations at such premises that do not involve changing the size of or moving buildings or other structures.
OWNERS' OR CONTRACTORS' PROTECTIVE LIABILITY COVERAGE
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This insurance coverage provides for payment on behalf of the insured of all damages the insured becomes legally obligated to pay due to bodily injury or property damage caused by an occurrence rising from the following:
• Operations performed for the named insured by independent contractors.
• Acts or omissions of the named insured in connection with his/her general supervision of such operations.
This does not include maintenance and repair at premises owned by or rented to the named insured, or structural alterations at such premises that do not involve changing the size of or moving buildings or other structures.
POLLUTION LEGAL LIABILITY COVERAGE
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Coverages
1. Pays on your behalf all sums you are legally obligated to pay as a result of emission, discharge, release, or escape of any contaminants, irritants, or pollutants into or on land, the atmosphere, or any water course or body of water, provided this results in "environmental damage."
2. Additionally pays to reimburse your expense for reasonable and necessary cleanup costs incurred in the discharge of a legal obligation validly imposed through governmental action, provided such expense is incurred because of "environmental damage."
3. Pays for defense of any claim or suit that is the subject of this insurance.
Coverage Response
"Claims made" coverage response (i.e., responds only to claims first made during the policy period and only for incidents that have occurred after the effective date of this coverage).
Pollution "Environmental damage" is defined in the policy as "the injurious presence in or on land, the atmosphere, or any water course or body of waterof solid, liquid, gaseous, or thermal contaminants, irritants, or pollutants."
PRODUCTS LIABILITY
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The liability for bodily injury or property damage incurred by a merchant or manufacturer as a consequence of some defect in the product sold or manufactured or the liability incurred by a contractor after he has completed a job as a result of improperly performed work. The latter described part of products liability is called Completed Operations.
PRODUCTS AND COMPLETED OPERATIONS AGGREGATE
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Liability arising out of the insured's products or business operations conducted away from the insured's premises once those operations have been completed or abandoned. An aggregate limit in an insurance policy stipulates the most it will pay for all covered losses sustained during a specified period of time, usually one year.
UMBRELLA LIABILITY COVERAGE
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This type of liability insurance provides excess liability protection. Your business needs this coverage for the following three reasons:
• It provides excess coverage over the "underlying" liability insurance you carry.
• It provides coverage for all other liability exposures, excepting a few specifically excluded exposures. This is subject to a large deductible of $10,000.
• It provides automatic replacement coverage for underlying policies that have been reduced or exhausted by loss.
Limit of Liability Premium
$1,000,000 $1,000,000
$2,000,000 $1,000,000
$3,000,000 $1,000,000
$4,000,000 $1,000,000
$5,000,000 $1,000,000
Notes and Recommendations
1. Higher limits are available and should be considered.
UMBRELLA LIABILITY COVERAGE EXTENSIONS
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(UNLESS EXCLUDED)
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Personal Injury Coverage -- Even if standard personal injury coverage is provided in the primary policy, the coverage provided by the Umbrella Liability policy is broader as it provides coverage for mental injury, mental anguish, shock, disability, humiliation, discrimination, etc.
Advertising Liability Coverage -- Included in the definition of "personal injury"
Blanket Contractual Coverage -- Included for both oral and written contracts.
Employers' Liability Coverage -- Claims made by employees are not excluded.
Worldwide Coverage
Liquor Law Liability Coverage
Non-Owned Aircraft Liability Coverage -- Also Owned Aircraft Liability coverage if included in the schedule of primary insurance.
Non-Owned Watercraft Liability Coverage -- Also Owned Watercraft Liability coverage if included in the schedule of primary insurance.
Drop-Down Coverage -- For occurrences within the scope of this coverage and in the absence of primary coverage, this will respond for your benefit subject to a $10,000 self-insured retention.
Additional Insured Coverage:
1. Officers, directors, and stockholders of the named insured, while acting within the scope of their duties as such. Also employees, but not with respect to their own automobiles.
2. Any additional insured named in the underlying insurance, for the same coverage as afforded thereunder.
3. Any person or organization to whom the named insured is obligated under written contract to provide coverage as is afforded under the Umbrella Liability policy with respect to operations by or on behalf of the named insured.
Care, Custody, or Control Coverage -- Excepting only liability assumed under contract, unless excluded.
Occurrence Coverage -- Matching the new standard primary policy definition.
Products and Completed Operations Coverage -- Using the new standard policy provisions.
X, C, AND U EXCLUSIONS
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Explosion ("X") Hazard
Includes property damage rising out of blasting or explosion.
Collapse ("C") Hazard
Includes structural property damage and property damage to any other property rising out of the following:
• Grading of land, excavating, burrowing, filling or backfilling, tunneling, pile driving, or coffer dam or caisson work.
• Moving, shoring, underpinning, razing, or demolition of any building or structure.
Underground ("U") Damage
Includes damage to wires, conduits, pipes, mains, sewers, tanks, tunnels, or any similar property beneath the surface of the ground or water caused by and occurring during the use of mechanical equipment for the purpose of grading land, paving, excavating, drilling, burrowing, filling, backfilling, or pile driving.
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